Key result
Despite resource limitations and logistical challenges, a multidisciplinary Heart Team approach for coronary artery disease is recommended and its implementation is possible in India.
Why the study?
Major cardiology societies recommend the Heart Team approach, but its evolution, benefits, scope, and specific implementation challenges in the Indian scenario required discussion.
A multidisciplinary Heart Team approach is recommended for patient-centric care in India, though specific models must be adapted to overcome severe workforce and resource limitations.
May support Heart Team consideration for CAD in India; leaves open prospective outcome studies.
PURPOSE: The European Society of Cardiology and the European Association for Cardio-Thoracic Surgery as well as the American College of Cardiology and the American Heart association have recognized the "Heart Team" as the best option for a patient centric treatment strategy and has granted a class I recommendation for its formation. The aim of this review is to discuss the evolution, scope and composition, the benefits, and problems inherent in its implementation in the Indian scenario. METHODS: A review of articles on Heart Team from cardiac surgery as well as multidisciplinary meetings from other specialties was performed. Advantages of Heart Team formation and its implementation have been critically evaluated and its applicability to the Indian scenario considered in particular. RESULTS: Heart Team formation is associated with many positives. Concern remains about the implementation of Heart Team approach in its true sense. Heart Team-led decisions are definitely patient centric despite multiple challenges in resource-limited environments. CONCLUSIONS: Despite the challenges, a multidisciplinary team approach in the form of Heart Team is recommended and its implementation possible in India. However, adjustments to the mechanism of implementation are required. Further research needs to focus on creating models for implementation and assessment of these models in terms of cost effectiveness, improved patient outcomes, and patient satisfaction in the process.
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Kunal Sarkar (2018) conducted a review in Coronary artery disease. Heart Team approach was evaluated. Despite resource limitations and logistical challenges, a multidisciplinary Heart Team approach for coronary artery disease is recommended and its implementation is possible in India.
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